Category: Childhood Experience

Abstract

Childhood trauma continues to be a problem psychosocially, medically, and as well as in the realm of public policy (De Bellis & Ziskm 2014). The Childhood Trauma Questionnaire (CTQ) was developed by Bernstein and Fink (1998) and has been widely used in research relevant to stress, depression, and substance use. The current paper discusses the development of the CTQ, the psychometric properties of the tool, the use and applicability in research, ethnocultural factors that need to be considered, and ethical consideration that are relevant to the tool. Finally, this paper concludes with other considerations to be aware of for future research.

Literature Review

Understanding how experiences impact mental health is key to identifying the severity of their current mental health status, the relationship between the event(s) and presenting mental health issue(s), and the plan to treat the client accordingly. However, understanding the impact of these experiences and the time in which they occurred during an individual’s life can allow a clinician (and researcher) to draw conclusions about how such events impact one’s health. Perry and Pollard (1998) stated that having an understanding of the nature, pattern, and timing of an individual’s experiences can influence subsequent functioning. They further claim that children respond to traumatic experiences and are affected by them in a variety of ways that can be expressed at various timepoints in their lives. Brain function and organization dependent on developmental and environmental experiences that get expressed by genes (Perry & Pollar, 1998; Teicher, 2000, 2002). Additional research conducted by Teicher, Samson, Anderson, and Ohashi (2016) identified physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect can have significant effects on the brain development of children which can be credited for adult psychopathology.

Goodman, Quas, Goldfarb, Gonzalves, and Gonzalez (2019) suggest traumatic events can affect long-term memory and accuracy depending on the impact imposed on an individual. The authors highlight two models related to adverse childhood experiences and the impact on human memory. The impairment model, which states that maltreatment is associated with deficits/distortions in both cognitive and socioemotional processes and also causes changes and/or impairments in neurobiology (Loman & Gunnae, 2010) and brain development (Teicher et al., 2003) might also impact memory. The second model, the conditional adaptation model, argues that maltreatment during childhood leads to “specialized mental functions” to be able to respond to threating and stressful environments (Ayoub & Fischer, 2006; Frankenhuis & de Weerth, 2013). However, it is stated that these specializations do not alter associative processes that affect memory but instead lead to heightened awareness and attention. Goodman and colleagues examined age of maltreatment, type of abuse, traumatic impact, attachment, and psychopathology as predictors of long-term memory. They concluded that the greater the traumatic impact that was experienced, the more accuracy the individual displayed in recalling the event(s). However, the authors noted that developmental factors, individual differences, and interviews moderate the effects of childhood trauma on adulthood memory accuracy related to the event(s).

Adverse childhood experiences have long been associated with individuals who are substance users and/or suffer from addictions. According to Dube and colleagues (2003), it was concluded that for each adverse childhood experience increase, the likelihood for early drug use initiation increased by a factor range of two to four times. The researchers also found evidence suggesting adverse childhood experiences were also associated with parental drug use. Participants with no adverse childhood experiences reported less illicit drug use problems, addiction to drugs, and parental drug use. When comparing participants with no adverse childhood experiences to those with 5 or more adverse childhood experiences, individuals with 5 or more adverse childhood experiences were more likely to report illicit drug use, addiction to drugs, and parental drug use. As a result, the researchers concluded that adverse childhood experience scores had a strong relationship with early drug initiation from childhood to adulthood, drug addiction, and parental drug use.

The Development of the CTQ. Bernstein and colleagues (1994) aimed at creating, testing, and validating a measure that would measure child abuse and neglect retrospectively. According to the authors, participants (n = 286) were identified as being drug or alcohol dependent patients. As mentioned in the literature review, individuals who underwent adverse childhood experiences have been strongly associated with drug use and addiction. Kandel (1998) found evidence suggesting drug use initiation tends to occur during the adolescence time period of development. Thus, Bernstein and colleagues were targeting a group of people in which were becoming increasingly studied to help understand a phenomenon.

To adequately draw conclusions from the 286 participants, the CTQ was administered as part of a battery of tests. Forty patients who were involved in the study were given the CTQ at subsequent months after their initial completion, while a total of 68 patients underwent the Childhood Trauma Interview. The Childhood Trauma interview, an interview created by the authors, is a structured interview in which child abuse and neglect is of focus.

The Psychometric Properties of the CTQ. After completing data collection, the data suggested four factors existed in the CTQ. The four items that were initially identified were physical abuse, emotional abuse, sexual abuse, and physical neglect. At this point in time, emotional neglect had not yet been established in the initial version of the CTQ, nor had the three additional minimization questions been established as a part of the measure. The addition of the emotional neglect subscale and the three minimization questions would eventually be established in the final version that was published in 1997. In addition, the CTQ yielded strong test-retest reliability (intraclass correlation = 0.88) for the 40 patients who were given the CTQ after their initial completion. Furthermore, convergence between the CTQ and the Childhood Trauma Interview was strong and was indicative of strong stability over time between the CTQ and the Childhood Trauma Interview. The authors concluded there was strong initial support for the CTQ.

The CTQ in which would eventually be published in 1997 by Bernstein and Fink would undergo more additions and testing. The published version of the questionnaire currently has a total of 28 items. Emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect each consist of five items. Each item-response is based on a five-point Likert-type scale ranging from Never True to Very Often True. The scores of each item are then summed to create an overall index score. The total score ranges from five to 25, with a score of 25 being the high score possible and indicating sever maltreatment. According to the testing guidelines, an individual’s scores can be compared to other data which is supplemented with examples to aid in interpreting scores.

The three items remaining in the 28-item measure is known as the Minimization/Denial Scale. These three items are intended to pick up on underreporting of maltreatment or false negatives. It is suggested that these items are going to be made apparent when there are low trauma scores. To understand these items in relation to the measure itself, the testing guidelines for the CTQ states that for each item (of the specific 3 items), each time the items are rated as Very Often True (the highest score possible for each item), a single point is given to each of them. As such, this three-item scale has scores ranging from zero to three. The testing guidelines provide detailed instructions as to how these scores should be handled should a person score a one, two, or three. Additional data would be needed to understand if abuse and neglect truly are/were absent or not.

Cut-off scores were established after validating the measure and subsequently testing the measure among a randomly selected “normal” sample of female members. There were four classifications that were established: none (or minimal), low (to moderate), moderate (to severe), and severe (to extreme). The measure would undergo further testing to establish norms. According to the Pearson Website (n.d.), the sexual abuse subscale has an internal consistency ranging from 0.93 to 0.95. The emotional neglect subscale has an internal consistency of 0.88 to 0.92. The emotional abuse subscale has an internal consistency of 0.84 to 0.89. Finally, the physical abuse subscale has an internal consistency ranging from 0.81 to 0.86. No internal consistency coefficients are reported for the physical neglect subscale, according to the Pearson website. The site states the test-retest coefficient over a three-and-a-half-month period of time is approximately 0.80. Finally, the site states that the factor analysis for the five-factor CTQ model demonstrates good validity due to the model showing structural invariance.

To further understand the psychometric properties of the CTQ, the measure has also been used in a community sample. Previous research has largely focused on clinical samples. However, Scher, Stein, Asmundson, McCreary, and Forde (2011) applied the CTQ in a community sample to understand the psychometric properties and establish norms for this measure in a non-clinical sample. In this study, Scher and colleagues had a combined total of 1,007 male and female responders from the state of Tennessee. The age range of the sample was 18 – 65. Six hundred thirty-seven responses came from females. Of particular interest (but to little surprise), only five participants identified as Hispanics, and only seven participants identified as Asians. A total of 428 participants identified as Black and 539 identified as White. Participants were recruited via a random digit generator as they were contacted by phone. Consistent with Bernstein and Fink’s model, Scher and colleagues also yielded a five-factor model. The measure yielded strong internal consistency (α = .91), consistent with the internal consistency of the CTQ applied in clinical samples. The sexual abuse subscale had an internal consistency of 0.94. The emotional neglect subscale had an internal consistency of 0.85. The emotional abuse subscale had an internal consistency of 0.83. The physical abuse subscale had an internal consistency ranging from 0.69. Finally, the physical neglect subscale had an internal consistency of .58. Internal consistency discrepancies clearly exist for the emotional abuse and physical abuse subscale in relation to the community sample. Overall, however, Scher and colleagues suggested the CTQ was a reliable tool not only for clinical samples but also non-clinical samples.

Uses in Research. As mentioned in the literature review, there is a strong need to characterize childhood stress and understand the impacts it has on an individuals’ neurobiological make-up, cognitive development, social development, and substance use patterns, especially as environments continue to evolve as well as individuals. Dr. Byron Adinoff, an established stress, and addiction psychiatrist and researcher, led a group of researchers to investigate stress and childhood trauma/adversity in a group of male alcohol-dependent veterans. The CTQ was one of the measures used in the research study. According to their findings, the data suggested that childhood trauma was a significant predictor of drinking severity in alcohol-dependent males and was magnified when stress was ongoing. As such, it was concluded that early childhood trauma and adversity may, in fact, sensitize stress-response systems (Eames et al., 2014).

Zarrati, Bermas, and Sabet (2019) aimed to investigate the mediating role of what they defined as mental pain in the relationship between childhood trauma and suicidal ideation. A total of 371 students at a university in Tehran, Iran were recruited to participate in the study. As part of the study, participants completed the CTQ, the mental pain scale of Orbach and Mikulincer (OMMP), and the Beck suicide ideation scale (BSSI). Based on their analyses, the authors concluded that childhood trauma had both direct and indirect influences on suicidal thoughts through what was defined as mental pain. However, the authors made a clear distinction that their sample were students. Thus, it was suggested in their study to examine a clinical sample to identify if results hold true.

The CTQ has also been used to study adolescents in Turkey. Turan and Tras (2017) recruited participants in grads nine through 12, ranging 15 – 18 years of age. In all, there were a total of 567 students participating in the study. Specifically, the researchers were interested in understanding the relationship between traumatic experiences during childhood and the participants’ perceived social support. In conjunction with the CTQ, the Scale of Perceived Social Support was also used. The data suggested significant differences existed in the physical, emotional, and sexual abuse subscales such that male students experienced higher scores in comparison to females – inconsistent with other prior research. Additionally, the researchers also concluded that those who have experienced physical, emotional, and sexual abuse had lower perceptions of social support compared to those who had not experienced such abuse.

As shown in the previous parts of this review, the use of the CTQ has been applied in various types of groups (clinical vs. non-clinical) and across people worldwide. Because of the strength of this measure, the need to adapt the CTQ became apparent. Thus, the measure was translated into various languages such as German, Spanish (Spain), Portuguese (Brazilian population), Italian, and French. Hernandez and colleagues (2013) aimed to validate the CTQ in Spanish (Spain). Participants were 185 inpatient and outpatient females. The age range for the participants was 18 – 65 years with a mean age of about 41 and were recruited at various mental health facilities throughout Reus, Spain. For the purposes of validating this measure in Spanish, the CTQ was translated into Spanish and was then back translated and was verified by master-level and PhD-level psychologists along with psychiatrists. The researchers conducted a CFA which yielded strong fit indices in support of the CTQ translated into Spanish, mirroring the original 28-item CTQ in English. Reliability for the CTQ-Spanish were comparable to the original version. However, it should be noted that the validation of the CTQ-Spanish was strictly used in a sample of Spaniard females. The researchers did not specify if the measure was applicable to other Spanish-speaking populations such as Spanish-speaking Latinos.

Ethnocultural Factors. Thombs and colleagues (2007) later analyzed data previously collected and published by Scher et al., (2001). Specifically, Thombs et al. sought to understand if childhood trauma/adversity differed between black and white participants in the Memphis sample. Specifically, the physical, emotional, and sexual abuse scales of the CTQ were examined for this particular analysis. After controlling for total physical abuse scale scores, Thombs and colleagues concluded that black participants were significantly more likely to report being punished with a physical object as compared to whites. However, data suggested that whites were more likely to have been hit to the point of marks appearing on their skin, were likely to have been hard enough for someone else to notice, and were more likely to believe they had been physically abused as compared to blacks. Thus, the authors concluded

Parents want what is best for their children, and do what they can to provide for them. Protecting them from any harm or negative experiences they may face. Children have yet to go through development to be able to process different life experiences. Complex topics that children are not able to grasp just yet, such as death, war, poverty, natural disasters and things of that nature. With a full future ahead, their caregiver attempts to shield them from this in order for them to have a childhood full of innocence and care free, to have that little time period in their life where their actions do not face major consequences, and acquire their sense of morality. These experiences happen in life naturally, although inevitably, things life trauma can affect the mind and the brain. As much as they try to protect their children from harm’s way, there is a psychological effect that may occur and last until other stages of their lives.

Unlike adults, whose minds are developed to understand extreme experiences, children are continuously developing and undergoing pivotal stages in which it’s difficult to process certain experiences. In children specifically, trauma holds a unique and much larger distress. The National Child Traumatic Stress Network specifically defines it as, “when a child feels intensely threatened by an event he or she is involved in or witness”. Trauma has a bigger impact on children because of their ever changing and developing brains. “Abuse, neglect, under-stimulation, and prolonged shame reduce levels of endorphins, CRF, and dopamine and increase stress hormones and noradrenalin. This biochemical environment inhibits plasticity and creates a vulnerability to psychopathology” (Cozolino). According to The NCTSN, traumas range from bullying, community, natural disasters, domestic violence, early childhood, medical, physical abuse, refugee, sexual abuse, terrorism, and violence. The different rates of trauma vary on the type of sample, measure, informant source, and other factors. The American Psychological Association estimates that witnessing community violence ranges from 39% to 85% and victimization 66%. Youth sexual abuse are 25% to 43%. The race and ethnicity, economic status, and gender affects these rates of trauma in children as well as their reaction. Distress is universal in all victims of trauma, although the response to these traumatic events differ based off of the child’s age race/ethnicity, previous trauma exposure, and resources that are available to the child. Some of these reactions include: developing new fears, sleep disturbances, sadness, loss of interest in daily activities, irritability, reduced concentration, as well as, but not limiting to, the decline of school work.

In terms of psychology, children go through different stages. When children go through trauma, it can cause a shift in the way they think, and the way the brain behaves. An example of this is chronic hyper arousal which comes from a disruption in the child’s hormones. This puts the body in a state of high alert when thinking about the traumatic event, while the event may not occur, the body behaves if it is. This is one of the primary symptoms of PTSD or post traumatic stress disorder. This symptom is associated with a plethora of its own symptoms such as sleeping difficulties, irritability, constant anxiety, as well as, but not limited to a sense of guilt and shame (healthline.com). A child dealing with a lot of stress early on in their lives can affect the way their body regulates important hormones such as the stress hormone cortisol. The body shifts in a fight or flight response which was beneficial for primitive survival. This bodily function served useful, the traumatic experiences a child may recall puts the body in this state as if it were reoccurring. Furthermore, the brain’s function is altered through the stress a child may face. The increase of hormones during this stage of development affects many regions of the brain including the hippocampus, amygdala, corpus callosum, broca’s area, and the cortex – frontal lobes. Previously mentioned, the hormone cortisol is ever present due to trauma as it is responsible for the body to feel stress resulting in a decrease in size of the hippocampus, the sector of the brain for long term memory. A survivor of trauma can experience difficulties with the ability to learn, memorize, as well as attention. The amygdala’s primary function relates to the human bodies emotional reaction. Specifically, relating to the brain fear response to environmental stimuli (Edwards, 2005). Trauma causes changes to its function by making the body easily provoked emotionally as well as regulating their own emotions, thus, causing emotional instability. Trauma also impacts the corpus callosum, the region that connects the left and right side of the brain affecting coordination. The portion of the brain that is responsible for speech and writing is known as the broca’s area. Those affected by trauma may find themselves having difficulties speaking about their traumatic experience as well as a cognitive delay. “On the whole, children exposed to neglect may be more vulnerable to general delays in cognitive and language development. Neglected children and those raised in poverty may be more at risk of general cognitive delay than those exposed to abuse” (Mclean, 2016). Neglect and poverty as a child falls under the criteria for childhood trauma. Trauma’s impact on the frontal lobe, consequently reduces it’s activity. “Children with abuse-related PTSD have been found to have significantly poorer attention and executive function compared with a matched sample of non-maltreated children: they made more errors in tasks of sustained attention, and were more easily distracted and more impulsive than their matched peers” (Mclean, 2016).

Looking at the impacts that trauma has on the biology of the mind, brain and body, we can see, that the impacts these effects have on the day to day life of these survivors of trauma is especially important. Knowing what difficulties they have that has resulted from trauma can help them find different resources they may need or accommodations they may receive from a workplace, school, or even at home. To avoid certain triggers, or have a good support group of people to help guide through life’s difficulties. Those who have been impacted from complex trauma early on may experience body dysregulation. This is defined as ‘the over or under response to sensory stimuli’ (The National Child Trauma Stress Network). This can affect the victims throughout their life, from different sensations. This child stress network also describes the sense of hypersensitivity to smells, touch, light, or sounds. As for the under response aspect, they may suffer from anesthesia and analgesia, which describes the phenomenon of one not being able to feel sensations of pain, or being aware of suffering from any physical issues. “In patients with PTSD, stress-induced analgesia is a key component of the broader phenomenon of dissociation, which also entails depersonalization and derealization” (Journal of Psychiatry & Neuroscience, 2011). While this may seem like a good thing, but in actuality can make certain issues go unnoticed. This makes it especially important to be wary of the mental health of children that suffer from experiencing and witnessing very traumatic events. While some may argue that children are too young to comprehend these events is the same reason why it is harmful to them. Furthermore, the effects on the adolescent stages of development or puberty, takes on a different form.

Violent crime is a notion of what constitutes violence can vary not only between different societies but also between groups with the same society at different times and in different contexts. Violent offending can have many factors explaining why a person would commit a crime that perplexed humankind; these include biological, psychological, social, and economical. Although, we will be mainly focusing on the psychological factors dictating how it can cause unusual behaviour; these include mental illness, depression (aggression), and personal traits. Offenders that suffer from these psychological factors can be apathetic towards crime, which could lead to more significant crimes as they will not fear punishment as much as others. Even though they get punished for the committed crime, they might find it difficult to reintegrate with society, which they might then re-offend.

Many people think that mental illness can lead to violent offending. Nevertheless, the Mental Health Act 1983 contains four different categories that must contemplate when looking at the development of the mind. Therefore, mental illness can observe psychopathic disorder, schizophrenia, progressive disorder (depression), and hysteria. These factors could have severe disruptions to a person’s mood and behaviour, as they will fail to function according to the standard attributes and traits. The statistics empathize, psychological problems are prevalent in the prison population. Birmingham 1996 reported that twenty-six percent of remand prisoners at Durham jail were suffering from one or more mental disorders. It is arguable; the mental illness could progress in the prison-terms, which then make it difficult to deter when the individual is released.

Schizophrenia may be genetic in some situations, depending on what might have triggered them in the past. Many studies show us that there are subtle differences in the structure of their brains, which is why it might be known as a disorder. People experiencing this mental disorder tend to use drugs, and this increases the development of schizophrenia and lead to delinquency. Nevertheless, schizophrenia is mostly related to violent crime, as the perpetrators find it challenging to experience emotional thoughts. Taylor, 1986, found a high level of schizophrenia among life-sentence prisoners in London. The development of alcohol and drug use can lead to symbolising psychopathology – as psychiatric disorders characterized by unusual behaviour, such as anti-social personality disorder, attention disorder, and conduct disorder.

These disorders have a significant impact on the functioning of life. An environmental factor might have triggered an innate response in the individual’s personality and its development that allows the individual to engage in immoral behaviour. Police authorities have recognised that alcohol’s effects on the mind and body, and this makes it likely to induce antisocial behaviour, leading to violent behaviour.

Reportedly 592,000 violent incidents alcohol motivated most of the offenders, yet there were underreported crimes that go uncounted, which reduces the statistics but maybe a more significant problem. People who have schizophrenia or similar mental illness are likely to isolate themselves from society as they do not tailor themselves with other people. Unfortunately, this creates a higher possibility for delinquent behaviour as they have a feeling of loneliness, which then prompts the individual to utilize harmful substances such as drugs and alcohol. Consequently, this can result in jealousy, which other word is called delusional jealousy which has a connection to many mental conditions, schizophrenia being one of them. Delusional jealousy is highly destructive on its own; it can cause immense damage and can lead to obsessive or even violent behaviour. Therefore, using drugs, such as marijuana, cocaine, and amphetamines, can exacerbate the symptoms and worsen the severity of the crime. The main problem with schizophrenia is that the person does not diminish any emotional expression or feelings, which can mean that the criminal act could be outrageous due to a lack of empathy and apathy. People with schizophrenia and AUD often report that they use alcohol and other drugs to alleviate the general dysphoria of mental illness, poverty, limited opportunities, and boredom; they also report that substance use facilitates the development of an identity and a social network.

For instance, poverty correlates with poor education, social isolation, and in adolescence, substance misuse. If an individual is bought up in poverty, it could harm their development, which can turn into the risk of self-harm and violence. As a child, they will feel ashamed from their parents as they cannot provide them anything useful, which will then cause aggression and depression. Their lives start to be disruptive and loss of hope as there is no peace in the house. Most of them start spending more time with their peers and witness violent behaviour more often, allowing them to normalise the situation as time passes. They might even influence the same thing at home, which can leave a distinct trauma, causing them to act in a way that is against the criminal justice system. The research indicates that many children were able to describe violent attacks they have witnessed in their early childhood. These attacks were generally horrendous and persistent. For example, Freud 1994 has stated that the arguments could occur by loss of income and status, relating to arguments concerning blame, which could then cause a high level of irritation between the two people. These children can suffer long-term severe emotional effects, such as depression and aggression, due to traumatizing experiences in the past. It could affect their self-confidence, which can result in different reactions. For example, boys will express their anxiety and anger by becoming aggressive. Due to what they have experienced in the past, they can conclude that violence can solve problems.

Psychologists name this type of behaviour as ‘post-traumatic’ disorder, and this can also lead to misuse of drugs and alcohol for older children as they see it as a stress relief. People suffering from ‘post-traumatic’ disorder can experience a lot of symptoms, such as concentration and memory. Chronic and prolonged exposure to violence may evolve into a dysfunctional routine perpetrated in both family and community context creating “a link between experiences of violence as victims and later experiences of violence as a perpetrator”. Meaning that violence can grow with a lifetime, an individual is whom experience violence can offend. These people tend to find alcohol and drugs as a solution to feel eased after being overwhelmed with horrible reminiscence.

Research shows that drinking loosens moral restraints and that people who drink lose personal control are consequently liable to behave in an anti-social way, including acting violently. Alcohol has an intended effect as they find it difficult to concentrate at school. It is found that anger and irritability, both measurables states, have been identified as empirically related among veterans to be associated with increased violence and aggression. Missing out from education can result in a long-term issue, as the individual will be unemployed in the future. Lack of education can then result in violent crime, in a review of 63 studies of unemployment and crime, Chiricos 1987 found a positive relationship, especially for property offense. People tend to prefer the quickest way for short-term gratification; they want to get entitled to something so they can fit in with the crowd.

Freud believed that events in our childhood have a significant influence on our adult lives, shaping our personality. According to Sigmund Freud’s theory of the psyche, there are three entities: Id, Ego, and Superego. Id is the personality component which aims to satisfy needs and desire; for example, if an individual is feeling angry or depressed, they will do anything to feel better. Unfortunately, it is inevitable to fulfil the needs and desires they feel entitled to as it will not be realistic and possible. The second component is the Ego, which is responsible for dealing with reality; in other words, balancing the Id and makes sure that the impulses of the Id are expressed appropriately to society. Finally, there’s the Superego, which brings together all of our internalized moral standards and ideals what we learn from our parents and the society (right or wrong). It civilizes our behaviour and suppresses all unacceptable actions of the Id Freud appears to differentiate between aggression, in the sense of the desire to subjugate or master, and sadism, though both are considered to be libidinal impulses. They are both categorised to be libidinal impulses, which links to the Id, and if the Ego fails to imbalance these elements, it can lead to unstable personality. The Id being dominant can result in the individual being uncontrollable, or even criminal.

Psychoanalysts now look at the negative trauma, which is not as incest, as the birth of a sibling, or an aggressive attack, but rather is a lack of psychological connection. This focus emerges from the many studies of the narcissistic personality disorder over the past decade. In this case, people that suffer from traumatic individuals might develop a narcissistic personality that could inhibit the individual from feeling empathy with someone else. Therefore, when a person feels no sympathy or empathy towards someone, they are more than likely to be violent when feeling aggressive and irritated. In other words, it might even generate a huge destructive crime scene as they will not feel any sorrow. Ego aiming to satisfy the demand of the Id should be unconscious at this point as it cannot be responsible for repression while also being the seat of consciousness. Freud’s hypothesis indicates that Ego development entails the renunciation of narcissistic self-love in favour of the aggrandizement of cultural and ethical ideals, which is given to the child by the influence of parents. Consequently, the development of the narcissistic self-love can mean that the individual can become egotistic towards others, and this will reduce the remorse and make them even more violent. They might want to express their indignation and passion in their adolescence, as they were not able to in their childhood.

Conclusion

Violence can be divined; it is possible to assign different probabilities of violence to population members based on the personalities and characteristics of people. Even though there are concerns with the reliability of prediction violence, psychologists can always deter future crimes as they deal with many of them and know how criminal behaviour and why they chose to behave in this way. As discussed previously, the family background appears to one of the psychological factors that can inherit violence in an individual from their childhood experiences. As well as drugs being involved and having power in criminal activities, it can provoke a person to behaviour abnormal and unusual. Most importantly, violence and mental illness have appeared to be that it could have a significant impact as some psychological scales indicate a propensity towards violence. Consequently, if they do commit a crime and get punished, they might find it difficult to reintegrate with society as they will find it challenging to adapt to society.